CMS Formulary

Displaying 134241-134250 of 1611142 results.
ID: 134241
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149373
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134242
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149376
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134243
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134244
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134245
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 862013
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134246
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 862019
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134247
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 862025
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134248
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 201388
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134249
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134250
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1737578
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0